The recent healthcare overhaul has hospitals preparing for the worst, anticipating a future in which they’ll be the ones paying for rising medical costs with little help from states looking to trim their own budget.

In turn, more and more hospitals across the country are looking to reduce their spending by reducing nurses’ pay and benefits. But many healthcare workers, bolstered by the dearth of unions in this sector, have increasingly begun to push back against the proposed cuts.

The labor strife has grown in states like Minnesota, where more than 12,000 nurses are slated to go on their second strike after Independence Day if the union and hospital management cannot agree to key issues in a new labor contract.

Nurses at 14 hospitals throughout the Twins Cities have been without a new dealsince March over disputes concerning staff-to-patient ratios and proposed pension reductions by one-third. They first struck on June 10 (video below).

Negotiations continued until late Tuesday night but “little progress” was made, according to the latest update by the Minnesota Nurses Association (MNA). The union modified pay and staff proposals, but they rejected the latest offer. Hospitals said they would maintain pensions but suggested the creation of a task force to address nurse workloads, but unions noted a similar concept by the legislature “failed miserably” last year.

Another return to the bargaining table is scheduled for today (Wednesday). Last Friday, the MNA filed their 10-day notice to start an open-ended strike scheduled to begin on July 6 at 7:00 a.m if negotiations are not settled.

The union is hoping to standardize staffing levels in the name of patient safety, but hospitals claim it is too expensive. Many hospitals across the country are short-staffed and nurses take on more patients than they can handle during their typical 12-hour work days. That creates a climate of not only overwork but can potentially cause medical mishaps. The MNA hopes to reduce the ratio to one nurse for every four patients in an effort to prevent more than 72,000 yearly deaths, according to a journal reportin the August 2005 issue of Medical Care.

Hospitals claim it will cost $250 million a year to sustain those levels at a time when they are looking to cut costs. Minnesota reduced its health payments to hospitals for Medicaid. And a report by the Congressional Budget Office wrote that hospitals will be required to pay for $113 billion as a result of Obama’s healthcare plan over the next decade.

But that doesn’t mean that times are rough for them: hospitals in the Twins Cities made a $700 million dollar profit last year and make more than $7 billion in annual revenue, the union said. Essentially, the pension would only cost a little more than 1 percent of their yearly revenue.

Even so, a contract is yet to be settled leading up to July 4th. During the impasse, hospitals hired 2,800 nonunion replacement staff during the one-day June 10 strike. Since then, more than 4,000 temporary permitshave been issued to work in Minnesota. A staffing agency has also been hired to bring in nurses willing to cross the picket line, enticed by offers of free airfare and hotel stays.

The union opposition to the proposed rollbacks stemmed from a one-day strike earlier this month, but it was also a measure of solidarity with fellow registered nurses who are increasingly joining unions. The June 10 strike by the Minnesota Nurses Association was also part of a new push with California Nurses Association to call attention to workers’ rights in the healthcare industry.

The nurse strike was touted by the union as the largestin U.S. history. California RNs have been trying to strengthen safeguards for hospitals to follow the state mandated minimum staffing ratios.

The two groups are affiliates of the 150,000 member National Nurses United (NNU), the “super union” formed from various state associations in December that, as we’ve reported before, has become the new face of labor.

Although a San Francisco judge blocked nurses from the University of California from striking, the NNU has become an active force in the industry. Within the last six months, the union has added 5,500 more nurses from Texas, Nevada and Illinois.

The national representation has grown as many local unions have come to the realization that many of the problems like safe staffing, cutbacks and changes from national healthcare reform have been occurring in hospitals nationwide.

Still, patients and doctors are caught in the middle of the dispute, and an ongoing strike can be harmful to the quality of patient care. Researchers at the National Bureau of Economic Research studied New York nurses’ strikes from 1984 to 2004 and found an increase of deaths and hospital re-admissions during labor disputes. The report, released in March, said in-hospital deaths rose by 19.4 percent while re-admissions increased by 6.5 percent during strikes.

Even as hospitals look to cut costs, financially, a strike is not in their best interestseither. With economic and health risks at stake, hospitals are looking to pinch every penny while nurses have an increasingly taxing workload. The emergence of the NNU and their affiliates will surely challenge the workplace rollbacks as nurses try to institute manageable staffing across the country.

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